| NPI | 1003806084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 17500) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MO 106644) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2018-03-17 |