| NPI | 1659378263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 200300054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200300054) |
| Enumeration Date | 2005-06-29 |
| Last Update Date | 2007-11-08 |