| NPI | 1386095743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 59849) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: AZ 59849) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2020-06-02 |