| NPI | 1427077189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D25205) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D25205) |
| 207R00000X Internal Medicine (Licence: MD D25205) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-12-10 |