| NPI | 1417308065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX V8229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.069420) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2026-08-28 |