| NPI | 1124522107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 286805) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 286805) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2026-04-13 |