| NPI | 1316527674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MT222887) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD485062) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2025-06-16 |