| NPI | 1215564752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036.164667) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.075677) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2026-05-12 |