| NPI | 1649403205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35 098565) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY P71891) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2016-03-31 |