| NPI | 1225133390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 47008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G79450) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G79450) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2021-05-07 |