| NPI | 1235361759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 049613) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 049613) |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2022-09-12 |