| NPI | 1750377412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NM MD2004-0754) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NM MD2004-0754) |
| 207R00000X Internal Medicine (Licence: NM MD2004-0754) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2021-02-15 |