| NPI | 1881257152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 98016) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 96341) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2026-08-05 |