NPI | 1720185630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME100463) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 237061) |
207P00000X Emergency Medicine (Licence: FL ME100463) | |
Enumeration Date | 2006-09-20 |
Last Update Date | 2014-11-04 |