| NPI | 1043257090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 77557) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 62453) |
| 207U00000X Nuclear Medicine (Licence: IA 34402) | |
| 207U00000X Nuclear Medicine (Licence: MA 223248) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-01-13 |