| NPI | 1053451328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A11542) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NV 718) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2016-10-03 |