| NPI | 1912267030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: SD 8422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 8422) |
| 207RI0200X Internal Medicine Infectious Disease (Licence: SD 8422) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2013-07-31 |