NPI | 1760781553 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AK 142762) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD 60398110) |
Enumeration Date | 2011-03-21 |
Last Update Date | 2019-09-03 |