| NPI | 1760404768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NV 14040) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 36279) |
| 207R00000X Internal Medicine (Licence: WI 36279) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-03-10 |