| NPI | 1053643007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 14202) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OR MD09249) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NV 14202) | |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2016-10-19 |