| 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 | 2025-08-05 |