| NPI | 1427210426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 41238) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 41238) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX N1779) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2025-10-07 |