| NPI | 1871500793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: RI MD14762) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD23547) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60418010) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2014-10-01 |