| NPI | 1902296882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0077427) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 280779) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2026-08-03 |