| NPI | 1548261738 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301063911) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301063911) | 
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MI 4301063911) | |
| Enumeration Date | 2005-08-10 | 
| Last Update Date | 2018-12-28 |