| NPI | 1619918596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD12535) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00030616) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-12-03 |