| NPI | 1083610117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MS 09945) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 09945) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2025-05-15 |