| NPI | 1902841810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 35717) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A88593) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2022-04-06 |