| NPI | 1184696148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: VA 0101058925) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101058925) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2022-04-19 |