| NPI | 1477596039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D27211) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D272-11) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2021-09-13 |