| NPI | 1689831257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: FL ME107623) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME107623) |
| 208600000X Surgery (Licence: PA mt188847) | |
| 2086S0129X (Licence: IA MD-44080) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2024-02-29 |