| NPI | 1205093473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2008007521) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2004-012733) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2008007521) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2021-03-15 |