NPI | 1659900710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME151743) |
Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: MN 73810) |
Enumeration Date | 2020-04-02 |
Last Update Date | 2025-05-05 |