| 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 |