| NPI | 1114313434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 67210) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AK 143025) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2022-11-08 |