| NPI | 1447224191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: RI MD12353) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.120371) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2019-11-25 |