| NPI | 1316160468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TN MD54101) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA 38425) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2022-03-16 |