| NPI | 1487158523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 327547) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC MMD.94016) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2026-03-16 |