| NPI | 1366558975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R7F57) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO R7F57) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO R7F57) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-01-05 |