| NPI | 1366463218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G48422) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G48422) |
| 207Q00000X Family Medicine (Licence: CA G48422) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-12-20 |