| NPI | 1316016504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: DC 17577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD 17577) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-03-25 |