| NPI | 1487870127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60485447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 37136) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA 37136) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-04-01 |