| NPI | 1386091767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME142044) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KY TP055) |
| 208M00000X Hospitalist (Licence: KY 57195) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2024-06-27 |