| NPI | 1982679320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 38074) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MN 38074) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 38074) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-08-20 |