| NPI | 1609360692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD70028862) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD70028862) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2025-11-03 |