| NPI | 1598904690 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301083859) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301083859) | 
| Enumeration Date | 2009-02-12 | 
| Last Update Date | 2025-09-09 |