| NPI | 1699725671 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR C-4828) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL 26919) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2010-10-14 |