| NPI | 1699736579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WA MD00033351) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MT 12295) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-03-12 |