| NPI | 1962494757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00024594) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD00024594) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2020-10-01 |