| NPI | 1538131818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2007-01042) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 01042) |
| 207R00000X Internal Medicine (Licence: VA 0101055588) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 2007-01042) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2023-10-03 |