| NPI | 1720773518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101289318) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116037778) |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2026-07-02 |