| NPI | 1447693056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 79473) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 79473) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2020-01-29 |