| NPI | 1396474482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 347211) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL88056) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2025-06-18 |