| NPI | 1467433748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA 38593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 38593) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 38593) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2009-11-17 |