| NPI | 1043210792 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX H3914) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H3914) | 
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: TX H3914) | |
| 2085B0100X Radiology, Body Imaging (Licence: TX H3914) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX H3914) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX H3914) | |
| Enumeration Date | 2005-07-22 | 
| Last Update Date | 2022-01-27 |