NPI | 1619080215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A34736) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A34736) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2011-05-11 |