| NPI | 1497710545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A81614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME146737) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX K9475) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2024-05-01 |