| NPI | 1780783647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME101797) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 42909) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2019-05-16 |