| NPI | 1114903879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR C7540) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: AR C7540) |
| 207Q00000X Family Medicine (Licence: AR C7540) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: AR C7540) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: AR C7540) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AR C7540) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2021-05-20 |