| NPI | 1295720613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G45949) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA G45949) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2007-09-13 |