| NPI | 1679573760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: LA 023177) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: LA 023177) |
| 207U00000X Nuclear Medicine (Licence: LA 023177) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2019-03-06 |