| NPI | 1568740843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301095739) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301095739) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2016-06-10 |