| NPI | 1265648810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 261597) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD12677) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI MD12677) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: ME 018440) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2024-08-05 |