| NPI | 1164004818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 51117) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD485041) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2025-07-23 |