| NPI | 1659938504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 94682) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL82223) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2025-08-12 |