| NPI | 1982393278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 1021990) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 3013642) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2025-05-18 |