| NPI | 1558369462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NC 9300699) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: SC 37441) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2023-09-06 |