| NPI | 1790309227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 202602837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 11864) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2026-07-01 |