| NPI | 1710281530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2011-00195) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 2011-00195) |
| Enumeration Date | 2011-01-08 |
| Last Update Date | 2014-05-07 |