| NPI | 1992771000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 23358) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: SC 23358) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2013-12-05 |