| NPI | 1609124759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2012003315) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2012003315) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2017-03-23 |