| NPI | 1104080639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: DE C1-0010967) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: DE C1-0010967) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: DE C1-0010967) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DE C1-0010967) | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: DE C1-0010967) | |
| 282N00000X General Acute Care Hospital (Licence: DE C1-0010967) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2020-02-26 |