| NPI | 1861502783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX L0784) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD207771) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD00046375) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2026-07-16 |