| NPI | 1558336131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: ME MD19931) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 40904) |
| 207R00000X Internal Medicine (Licence: ME MD19931) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2017-04-19 |