| NPI | 1689769085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: WA md00031441) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00031441) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2019-08-14 |