| NPI | 1376032698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101285396) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1022951) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2025-09-03 |