| NPI | 1063503597 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO 47514)  | 
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: CO 47514)  | 
| 207R00000X Internal Medicine (Licence: TX M3523)  | |
| 207R00000X Internal Medicine (Licence: CO DR.0047514)  | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE NE25255)  | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WY 9208A)  | |
| Enumeration Date | 2006-09-28 | 
| Last Update Date | 2016-12-01 |