| NPI | 1790771319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 43010037197) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: MI 4301037197) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: MI 4301037197) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2012-10-19 |