| NPI | 1790239101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2022-01767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2022-01767) |
| 207R00000X Internal Medicine (Licence: AR E-12710) | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2026-08-21 |