| NPI | 1346228921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KS 0429493) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2006018665) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2018-04-06 |