| NPI | 1912973397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101240384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 37126) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2010-10-21 |