NPI | 1396763595 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME55703) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME55703) |
207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME0055703) | |
Enumeration Date | 2006-07-17 |
Last Update Date | 2021-09-07 |