| NPI | 1851329957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301042561) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301042561) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2023-03-07 |