| NPI | 1457341463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 25812) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL 25812) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2020-11-05 |