| NPI | 1629118468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C39988) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: CA C39988) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: CA C39988) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-09-10 |