| NPI | 1811151723 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD60829836)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 54980)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60829836)  | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CO 54980)  | |
| Enumeration Date | 2008-07-10 | 
| Last Update Date | 2018-06-26 |