| NPI | 1992864177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: DC MD19927) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101054105) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D0042403) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-03-07 |