| NPI | 1417215252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SD 8483) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 43876) |
| 207R00000X Internal Medicine (Licence: SD SD) | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2019-05-28 |