| NPI | 1215027990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CO 27855) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO 0027855) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2025-05-08 |