| NPI | 1659349512 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 29915)  | 
| Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: AZ 29915)  | 
| 207U00000X Nuclear Medicine (Licence: AZ 29915)  | |
| Enumeration Date | 2006-03-08 | 
| Last Update Date | 2025-10-08 |