| NPI | 1235217944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NV 15607) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G52247) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2015-05-04 |