| NPI | 1497245047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2025-00865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2025-00865) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2025-08-27 |