| NPI | 1659344596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: CT 038204) |
| Additional Taxonomies | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: CT 038204) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2013-01-14 |