| NPI | 1770218539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 79092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 9318) |
| Enumeration Date | 2022-07-17 |
| Last Update Date | 2025-05-09 |