| NPI | 1356311385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME65005) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME65005) |
| 207Q00000X Family Medicine (Licence: FL ME65005) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2012-07-11 |