| NPI | 1730128489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: AZ 14918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 14918) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2014-09-22 |