| NPI | 1467535005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD0082571) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200401634) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD60082571) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-11-10 |