| NPI | 1679550156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 026267) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 026267) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2011-10-11 |