| NPI | 1720023021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 39206) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 39206) |
| 207RI0001X Internal Medicine, Clinical & Laboratory Immunology (Licence: TN 39206) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2012-10-23 |