| NPI | 1104910140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS-006313L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C2-0012667) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA OS-006313L) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: DE C2-0012667) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-06-04 |