| NPI | 1770523540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R7174) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-16758) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO R7174) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KS 04-16758) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2014-07-10 |