| NPI | 1396187696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD61385148) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA TBD) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR MD195835) | |
| Enumeration Date | 2013-07-27 |
| Last Update Date | 2024-05-10 |