| NPI | 1821175621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX E0779) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX E0779) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: TX E0779) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-01-31 |