| NPI | 1609825082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA G84045) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G84045) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2011-02-18 |