| NPI | 1912360470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 84383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D87800) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2025-09-02 |