| NPI | 1710276316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI LP04898) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2014015766) |
| 207R00000X Internal Medicine (Licence: IL 036-133812) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2021-06-07 |