| NPI | 1083678593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NC 23346) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 23346) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NC 23346) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2012-02-19 |