| NPI | 1942250659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME86600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME86600) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME86600) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME86600) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-06-15 |