NPI | 1164983011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 79819) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN29204) |
207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME150965) | |
Enumeration Date | 2019-03-25 |
Last Update Date | 2025-05-16 |