| NPI | 1801005632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VT 042.0013352) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 2008-00511) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IN 01069340A) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2016-06-09 |