| NPI | 1134569494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 52640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74164) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2023-05-08 |