| NPI | 1619408119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 86488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2021-01350) |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2025-06-13 |