| NPI | 1639163215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WY 12458A) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 1771421205) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: UT Utah1234) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WY 12458A) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2019-11-19 |