NPI | 1497082218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX U7377) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AL 33427) |
207R00000X Internal Medicine (Licence: IL 125056242) | |
207R00000X Internal Medicine (Licence: AL 33427) | |
Enumeration Date | 2009-11-16 |
Last Update Date | 2023-11-29 |