| NPI | 1235110545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D0067744) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: DE C1-0007096) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2011-03-14 |