| NPI | 1013123504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 235927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 235927) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2010-04-27 |