| NPI | 1376608125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX M5176) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 33308) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2014-08-31 |