| NPI | 1205066628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D26473) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D26473) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2009-07-20 |