NPI | 1336206143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NE 30712) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD427428) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2018-10-14 |