NPI | 1376104869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5151013716) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151013716) |
Enumeration Date | 2019-06-25 |
Last Update Date | 2022-06-27 |