| NPI | 1730443110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60834235) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-2558) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2018-07-24 |