| NPI | 1881616159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A35686) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A35686) | 
| Enumeration Date | 2006-07-24 | 
| Last Update Date | 2025-09-11 |