| NPI | 1184786857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 428989) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA MD-53053) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA C202767) | |
| Enumeration Date | 2006-12-15 | 
| Last Update Date | 2025-08-06 |