| NPI | 1962964718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA MD-55008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A177851) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-11-23 |