| NPI | 1639206535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036085519) |
| Additional Taxonomies | 174400000X Specialist (Licence: IA 27214) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IN 01038819A) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2011-11-01 |