| NPI | 1053995746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA OT020709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT020709) |
| Enumeration Date | 2021-05-08 |
| Last Update Date | 2024-06-04 |