| NPI | 1407992076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60750871) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 228746) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA C166443) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT 26096) | |
| Enumeration Date | 2007-01-30 | 
| Last Update Date | 2022-09-22 |