| NPI | 1033154018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C52794) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NE 22143) |
| 207R00000X Internal Medicine (Licence: NE 22143) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2018-07-03 |