| NPI | 1780757062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D59633) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD034269) |
| 207R00000X Internal Medicine (Licence: NM 9880) | |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: MD D59633) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-02-23 |