| NPI | 1831149905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00039185) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00039185) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-07-20 |