| NPI | 1871534636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA G86422) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA G84622) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2012-05-24 |