| NPI | 1811159924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 30902) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SC 30902) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: SC 30902) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2017-04-25 |