| NPI | 1932526514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A161893) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME124126) |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2021-07-22 |