| NPI | 1417913500 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 45984) | 
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 45984) | 
| Enumeration Date | 2006-04-26 | 
| Last Update Date | 2020-06-24 |