NPI | 1306306857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A179256) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A179256) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 318524) | |
Enumeration Date | 2019-03-21 |
Last Update Date | 2024-12-12 |