| NPI | 1952325466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 00011594) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL MD.11594) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-02-06 |