| NPI | 1144333030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R3C07) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO R3CO7) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO R3C07) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2014-08-01 |