| NPI | 1265489058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 153766) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 153766) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2024-03-26 |