| NPI | 1801025812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60232848) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 8228530-1205) |
| Enumeration Date | 2009-07-11 |
| Last Update Date | 2015-06-12 |