| NPI | 1225640105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 80788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 80788) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2025-06-25 |