NPI | 1225087604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD042760) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD030814E) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: NH 15852) | |
Enumeration Date | 2006-05-10 |
Last Update Date | 2015-01-06 |