| NPI | 1336197334 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60080391) | 
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: WA MD60080391) | 
| Enumeration Date | 2006-05-04 | 
| Last Update Date | 2011-07-20 |