| NPI | 1992834097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: DC MD5346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D17434) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101022954) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2021-12-08 |