| NPI | 1588658595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 30497) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 30497) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2013-02-20 |