| NPI | 1558742411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME147322) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME147322) |
| 208000000X Pediatrics (Licence: KS 94-08581) | |
| 208M00000X Hospitalist (Licence: FL ME147322) | |
| 207R00000X Internal Medicine (Licence: KS 94-08581) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2025-09-12 |