| NPI | 1205903994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A45617) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35-058968) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2024-12-05 |