| NPI | 1851851950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NM DO2022-0123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM DO2022-0123) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-07-08 |