NPI | 1558337022 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 20960) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN MD0000036916) |
Enumeration Date | 2006-02-24 |
Last Update Date | 2011-03-16 |