| NPI | 1902869415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 028828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 028828) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2013-05-31 |