| NPI | 1376580951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD33383) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: DC md33383) |
| 311500000X Alzheimer Center (Dementia Center) (Licence: DC md33383) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2014-10-17 |