NPI | 1255644555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 69193-20) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 14938) |
207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 270212) | |
Enumeration Date | 2010-07-15 |
Last Update Date | 2020-12-23 |