| NPI | 1194119545 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 21989) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 306417) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-04-25 |