| NPI | 1821626359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 112861) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 97613) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2026-08-27 |