| NPI | 1033897525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125082004) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 350460) |
| 207R00000X Internal Medicine (Licence: LA 350460) | |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2026-06-15 |