NPI | 1275866519 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA c33586) |
Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: CA C33586) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA c33586) | |
Enumeration Date | 2009-09-17 |
Last Update Date | 2009-09-17 |