| NPI | 1174523716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX D8876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX D8876) |
| 2085B0100X Radiology, Body Imaging (Licence: TX D8876) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX D8876) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2011-11-30 |