| NPI | 1356314181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204R00000X Electrodiagnostic Medicine (Licence: WA MD00020788) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00020788) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2012-04-09 |