| NPI | 1083664064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: HI MD10538) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL me77724) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |