| NPI | 1053322503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-119606) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A95863) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036.119606) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2018-12-26 |