| NPI | 1942696471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 291659) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2026-02708) |
| 207R00000X Internal Medicine (Licence: NC 2026-02708) | |
| 207R00000X Internal Medicine (Licence: MA 291659) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2026-06-19 |