| NPI | 1457368730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N7524) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA GA034540) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: TX N7524) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2017-01-31 |