| NPI | 1306823414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 35673) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MA 35673) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 35673) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2012-04-05 |