| NPI | 1285773101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101231528) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101231528) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2023-10-23 |