| NPI | 1255775805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME155094) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036140524) |
| 207R00000X Internal Medicine (Licence: GU MTL-2017-075) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2022-06-10 |