| NPI | 1487942124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 60827451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301099128) |
| 207R00000X Internal Medicine (Licence: WA MD60827451) | |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2020-04-09 |