| NPI | 1083144596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301507934) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301112414) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301112414) | |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2023-07-05 |