| NPI | 1891762787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX J8260) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 55430) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2025-01-15 |