| NPI | 1558821652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 22251) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 86306) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-11-25 |