| NPI | 1316177058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD460857) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 55783) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 55783) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 106111) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2021-03-25 |