| NPI | 1558336404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NC 26447) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 0026447) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2016-08-30 |