| NPI | 1437116142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G50213) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G50213) |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: CA G50213) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2023-04-27 |