| NPI | 1700834058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 2019-02737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01047350A) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2019-12-06 |