NPI | 1629161161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G31392) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G31392) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2007-09-12 |