| NPI | 1790783389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME50281) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0056697) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2024-01-12 |