| NPI | 1952484651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101260995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-047004) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2024-02-22 |