| NPI | 1801885280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX J4921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J4921) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX J4921) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2016-12-11 |