| NPI | 1457317232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX M7015) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01058184A) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2013-07-18 |