| NPI | 1235525015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 80428) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 66862) |
| 207R00000X Internal Medicine (Licence: WI 5709) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 66862) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2025-12-08 |