| NPI | 1487622569 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101102823)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101102823)  | 
| Enumeration Date | 2006-03-14 | 
| Last Update Date | 2024-10-10 |