| NPI | 1477852010 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AZ 006319) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R2115) | 
| Enumeration Date | 2011-03-22 | 
| Last Update Date | 2025-06-25 |