| NPI | 1538664750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MD D101933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D101933) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2026-08-19 |