| NPI | 1760878417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 67551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 67551-20) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 5699) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2022-07-08 |