| NPI | 1518022060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD00016013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00016013) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2008-05-08 |