| NPI | 1225097280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 9300258) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A48135) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: HI MD8274) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NC 9300258) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2018-09-13 |