| NPI | 1881681617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2015-01461) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 77820) |
| 207R00000X Internal Medicine (Licence: SC 39531) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2016-12-07 |