| NPI | 1568074920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 69584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30777) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 69584) | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2025-04-14 |