| NPI | 1306307301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101274313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101274313) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2025-07-07 |