| NPI | 1750384665 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: AZ 20241)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 20241)  | 
| Enumeration Date | 2005-05-24 | 
| Last Update Date | 2014-08-15 |