| NPI | 1538127154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME31620) |
| Additional Taxonomies | 2084P0805X (Licence: FL ME0031620) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-03-09 |