| NPI | 1508850736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI AR 040557) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI AR 040557) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2012-08-15 |