| NPI | 1831174887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN MD023946) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: TN A419654) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2011-09-07 |