| NPI | 1154550200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 53222) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 106836) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 53222) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2020-08-21 |