| NPI | 1629412895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD70006720) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD70006720) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2025-09-19 |