| NPI | 1417215906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 5999) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 5999) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 82962) | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2026-06-12 |