| NPI | 1174057491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2020-03751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT017581) |
| 207R00000X Internal Medicine (Licence: NC 2020-03751) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2025-07-10 |