| NPI | 1942257852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA 00093235) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A93235) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-03-12 |