| NPI | 1790424257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT226049) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 3019421) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2025-05-21 |