| NPI | 1073774485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: IN 432084194) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2010-09-16 |