| NPI | 1447711767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 104040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 104040) |
| 207R00000X Internal Medicine (Licence: FL OS18382) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-07-31 |