| NPI | 1699770651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 12334) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WV 12334) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2009-05-13 |