| NPI | 1972574275 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01054842A) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 24143) | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 71047) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35078350) | |
| 207P00000X Emergency Medicine (Licence: OH 35-07-8350-A) | |
| Enumeration Date | 2006-01-27 | 
| Last Update Date | 2025-08-19 |