| NPI | 1659323087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: WA MD00018359) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0072381) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2024-09-27 |