| NPI | 1811984537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: LA 15498R) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: LA 15498R) |
| 207UN0901X Nuclear Medicine Nuclear Cardiology (Licence: LA 15498R) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2015-07-27 |