NPI | 1003496449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036.170506) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-04-09 |
Last Update Date | 2024-08-05 |