| NPI | 1942663166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: CA A152391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A152391) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2022-01-06 |