| NPI | 1255413910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 102339) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MO 102339) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2024-06-19 |