| NPI | 1891965489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD462386) |
| Additional Taxonomies | 207RA0000X Internal Medicine Adolescent Medicine (Licence: MI 4301085923) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301085923) | |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2025-08-01 |