| NPI | 1902841810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 35717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ AZ35717) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A88593) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2025-02-24 |