| NPI | 1902037377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD60969350) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 107390) |
| 207R00000X Internal Medicine (Licence: IL 125.056815) | |
| 207R00000X Internal Medicine (Licence: WA MD60969350) | |
| 207R00000X Internal Medicine (Licence: IL 036.129998) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036.129998) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2021-05-18 |