| NPI | 1013020908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C027108) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA C027108) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2010-03-15 |