| NPI | 1598701690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA00711) |
| Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: OR PA00711) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2021-03-09 |