| NPI | 1821417395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CO DR.0060137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S7874) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX S7874) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2025-02-04 |