| NPI | 1033122742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 34364) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SC 16534) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-03-20 |