| NPI | 1427251123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 2009-01723) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 134715) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2018-06-07 |