NPI | 1770572422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD045958L) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA06219500) |
Enumeration Date | 2005-10-17 |
Last Update Date | 2021-05-18 |