| NPI | 1245307735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 044731) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: UT 2788561205) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: GA 044731) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2017-03-01 |