| NPI | 1679541403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: OK 23656) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 23656) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2011-01-13 |