NPI | 1174516751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KY 49556) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 49556) |
Enumeration Date | 2005-08-29 |
Last Update Date | 2016-11-02 |