| NPI | 1245205962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 24284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 30843) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-03-17 |