| NPI | 1174582001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA C130288) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 114879) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2021-11-18 |