| NPI | 1558673384 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 1558673384) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301096819) | 
| Enumeration Date | 2010-07-09 | 
| Last Update Date | 2025-05-21 |