| NPI | 1356311005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 10970) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AL 10970) |
| 207R00000X Internal Medicine (Licence: AL 10970) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL 10970) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2023-03-07 |