| NPI | 1780926808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 73827) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA 135101) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: CA A135101) | |
| 2471C3401X Radiologic Technologist Computed Tomography (Licence: CA A135101) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2023-10-01 |