NPI | 1205240520 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 67188) |
Additional Taxonomies | 208D00000X General Practice (Licence: MO 2017015418) |
Enumeration Date | 2014-06-13 |
Last Update Date | 2022-09-21 |