| NPI | 1447360698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OK 27943) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G32738) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-09-17 |