NPI | 1922369743 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A142990) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301100865) |
208000000X Pediatrics (Licence: MI 4301100865) | |
Enumeration Date | 2012-06-07 |
Last Update Date | 2021-11-23 |