| NPI | 1538105812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WA MD00017198) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00017198) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2012-10-30 |