| NPI | 1093451114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL TRN41485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R79481) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2025-06-29 |