| NPI | 1275565574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL 35474) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NC 200101356) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-09-15 |