| NPI | 1134154735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SC 36241) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G32480) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2026-07-21 |