| NPI | 1679687289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI MD05708) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD05708) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2026-03-06 |