| NPI | 1871669002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C41047) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 15591) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 048370) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-05-30 |