| NPI | 1376543611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 29366) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 29366) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2012-08-05 |