| NPI | 1235527169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME135642) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME135642) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2018-10-10 |