| NPI | 1205941127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: IL 036112303) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036112303) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-12-04 |