| NPI | 1700854379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: VT 0420011566) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: FL ME66475) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NH 8845) | |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: VT 0420011566) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-12-18 |