| NPI | 1871539973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR MD15370) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD15370) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD00049331) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2021-03-25 |