| NPI | 1760692529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OR MD28797) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WA MD.60218223) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2011-08-18 |