| NPI | 1851658900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX R6882) |
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: TX R6882) |
| 207R00000X Internal Medicine (Licence: OH 57.021667) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2026-05-31 |