| NPI | 1871933838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WA MD60894767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60894767) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2019-11-11 |