| NPI | 1700096161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 9500798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9500798) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2025-02-05 |