| NPI | 1083237275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD491466) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT220374) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2025-08-28 |