| NPI | 1710948187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 136288) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 2600) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2009-03-24 |