| NPI | 1336372010 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301093773) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60644313) | 
| 246XC2901X Spec/Tech, Cardiovascular, Cardiovascular Invasive Specialist (Licence: OR MD177136) | |
| 246XC2901X Spec/Tech, Cardiovascular, Cardiovascular Invasive Specialist (Licence: WA MD60644313) | |
| 207R00000X Internal Medicine (Licence: WA MD60644313) | |
| Enumeration Date | 2009-08-28 | 
| Last Update Date | 2025-09-04 |