| NPI | 1992778906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 25614) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 25614) |
| 207R00000X Internal Medicine (Licence: NC 25614) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2016-04-07 |