| NPI | 1720178445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D0030182) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D30182) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-12-13 |