| NPI | 1790738532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD00035551) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00035551) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ID M9435) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2012-10-05 |