| NPI | 1043349608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NM MD2011-0248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2011-0248) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2011-06-10 |