| NPI | 1205052990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A 113059) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD12318) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI LP00988) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2024-04-04 |