| NPI | 1861999781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX V9641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 64629) |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2025-07-10 |