| NPI | 1104389923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD61648231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61648231) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2026-06-10 |