| NPI | 1922560895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 71036) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 93643) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-06-30 |