| NPI | 1265444202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME80483) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME80483) |
| 207R00000X Internal Medicine (Licence: FL ME80483) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-12-13 |