| NPI | 1205214079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD21-1038) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A145719) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2023-08-08 |