| NPI | 1164516548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NM 85-45) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 8545) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-04-13 |