| NPI | 1811483381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 141951161205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL15150) |
| Enumeration Date | 2018-07-07 |
| Last Update Date | 2025-06-03 |