| NPI | 1710478847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL 32035) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: PA MT215309) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2023-11-22 |