| NPI | 1477763878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301082278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301082278) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2014-04-16 |