| NPI | 1316329139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD6128977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD6128977) |
| 207R00000X Internal Medicine (Licence: NE 31531) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2022-07-13 |