| NPI | 1902287246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 60837284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066987) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: WA 60837284) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2021-07-14 |