| NPI | 1225111743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 9501116) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9501116) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 9501116) | |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2024-02-19 |