NPI | 1669680872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301030107) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 30107) |
Enumeration Date | 2007-05-19 |
Last Update Date | 2022-05-10 |