| NPI | 1699723627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MA 207327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 207327) |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: MA 207327) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-09-29 |