| NPI | 1164579058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 36552) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 32387) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-12-27 |