| NPI | 1750933594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KY 61632) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073894) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2026-08-06 |