| NPI | 1093792939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MA 72280) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 72280) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2014-07-18 |