| NPI | 1043278484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2023008158) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2000163858) |
| 207R00000X Internal Medicine (Licence: OK 18452) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KS 0426982) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-03-08 |