| NPI | 1952415952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD60245440) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60245440) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: LA 202022) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 202022) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2015-01-14 |