| NPI | 1831707017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 73390) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE TEP8924) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2023-10-20 |