| NPI | 1518062819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KY 57755) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IN 01057692A) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2023-04-20 |