| NPI | 1922313774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 56324) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA IMLC.MD.70079176) |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2026-08-13 |