| NPI | 1588647887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IA 29836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 29836) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2015-05-08 |