| NPI | 1023646304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 336.123079) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 336.123079) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2023-10-10 |