| NPI | 1225397342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI MD14014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-126429) |
| 207R00000X Internal Medicine (Licence: RI MD14014) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2024-03-25 |