| NPI | 1730109679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301065735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301065735) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 39676) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-10-14 |