| NPI | 1760466981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA G26137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G26137) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2025-09-11 |