| NPI | 1588812689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WA MD60285495) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD155993) |
| 207R00000X Internal Medicine (Licence: WA MD60285495) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2021-08-10 |