| NPI | 1578599445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00028275) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00028275) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2012-10-05 |