| NPI | 1972135242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PR 24227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 294304) |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2026-08-12 |