| NPI | 1336372010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60644313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301093773) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60644313) | |
| 246XC2901X Spec/Tech, Cardiovascular, Cardiovascular Invasive Specialist (Licence: WA MD60644313) | |
| 246XC2901X Spec/Tech, Cardiovascular, Cardiovascular Invasive Specialist (Licence: OR MD177136) | |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2022-01-03 |