| NPI | 1114215563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD70026581) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 50273) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD482364) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 311264) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2025-12-09 |