| NPI | 1316986490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 36416) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 27102) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SC 36416) | |
| 207R00000X Internal Medicine (Licence: NC 27102) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2016-12-08 |