| NPI | 1891794905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 044919) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME76472) |
| 207U00000X Nuclear Medicine (Licence: CT 044919) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2010-08-12 |