| NPI | 1598051252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA OP60859930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT014097) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2018-09-10 |