| NPI | 1053579433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 46169) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036120955) |
| 207R00000X Internal Medicine (Licence: KY 46169) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2026-05-16 |