| NPI | 1225087604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD042760) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD030814E) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NH 15852) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2015-01-06 |