| NPI | 1316564958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101029185) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5101029185) |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2026-09-16 |