| NPI | 1568667715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME100751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME100751) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101242340) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2021-01-21 |