| NPI | 1083230916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 1026920) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP05091) |
| 207R00000X Internal Medicine (Licence: MS 31715) | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2026-08-03 |