| NPI | 1164583043 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KY 57574)  | 
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101050097)  | 
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME138875)  | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IN 01088782A)  | |
| Enumeration Date | 2006-12-13 | 
| Last Update Date | 2024-10-25 |