| NPI | 1376104869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD H0104268) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5151013716) |
| 207R00000X Internal Medicine (Licence: MI 5151013716) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2025-09-17 |