| NPI | 1770713125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036.130535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.056702) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2021-06-17 |