| NPI | 1295790780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2015-00086) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TN 17658) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2015-10-19 |