| NPI | 1922057454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00040988) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ID M8492) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-10-30 |