| NPI | 1376129312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 80650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A195430) |
| Enumeration Date | 2021-03-21 |
| Last Update Date | 2025-09-26 |