| NPI | 1922040245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301104150) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35079592) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX 43211) | |
| 207R00000X Internal Medicine (Licence: MI 4301104150) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-01-31 |