| NPI | 1336206143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NE 30712) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD427428) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2018-10-14 |