| NPI | 1679634869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101259014) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA md063059l) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D0075356) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2017-03-14 |