| NPI | 1922200377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 15880) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 268905) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: ME 017256) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2021-05-05 |