| NPI | 1235154204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 40996) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX K6309) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-05-13 |