| NPI | 1518491166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A176507) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 64178) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2022-08-02 |