| NPI | 1962468025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: ID M-13173) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D57945) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-05-23 |