NPI | 1528385614 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME119745) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 276764-1) |
Enumeration Date | 2010-04-28 |
Last Update Date | 2017-03-24 |