NPI | 1568957561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0072776) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL52838) |
Enumeration Date | 2018-06-22 |
Last Update Date | 2024-07-24 |