| NPI | 1174616684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A51671) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A51671) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A51671) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-08-20 |