| NPI | 1720736887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 87341-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MTL500002164) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2026-07-01 |