| NPI | 1972632297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 60331807) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 2046-850) |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2016-11-14 |