| NPI | 1093738635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D43121) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD D43121) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D43121) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-02-25 |