| NPI | 1396009874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: WA MD61054645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042.0013911) |
| 207R00000X Internal Medicine (Licence: MA 253007) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2020-08-19 |