| NPI | 1760440465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G22161) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G22161) |
| 207U00000X Nuclear Medicine (Licence: CA G22161) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2016-02-16 |