| NPI | 1265490379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SC 83746) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101037573) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2022-02-01 |