| NPI | 1932511565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD6074340) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA 60744340) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2020-11-12 |