| NPI | 1861483752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: ME MD20639) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 75389) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 75389) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2020-01-03 |