| NPI | 1558316869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 160367) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 200201203) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2021-11-09 |