NPI | 1053369280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: TX M4524) |
Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: IN 01053985A) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2010-11-18 |