NPI | 1952629057 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101250725) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101250725) |
Enumeration Date | 2010-05-13 |
Last Update Date | 2018-04-24 |