| NPI | 1003379736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101282424) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101282424) |
| 207R00000X Internal Medicine (Licence: PA MD478735) | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2024-07-30 |