| NPI | 1619064672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01065093) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: WI IN PROCESS) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-01-10 |