| NPI | 1497334387 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL MD.45031)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.45031)  | 
| Enumeration Date | 2021-04-07 | 
| Last Update Date | 2025-09-16 |