NPI | 1003101908 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT200230) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 37780) |
207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D85999) | |
Enumeration Date | 2011-06-20 |
Last Update Date | 2021-08-24 |