| NPI | 1386866333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2015016232) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: LA 200338) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2021-02-17 |