| NPI | 1174585376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A69001) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 160230) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2022-08-24 |