| NPI | 1639273147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OR MD10539) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD10539) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2021-11-12 |