| NPI | 1790168110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA C208563) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107238) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2026-06-20 |