| NPI | 1760034839 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL MD.50898) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.074578) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MT224796) | |
| Enumeration Date | 2019-07-09 | 
| Last Update Date | 2025-06-25 |