NPI | 1508815119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME81219) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME81219) |
Enumeration Date | 2006-05-09 |
Last Update Date | 2019-03-12 |