| NPI | 1245868819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 69743) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 69743) |
| 207R00000X Internal Medicine (Licence: MN 30758) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2026-09-08 |