NPI | 1730160573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 20393) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 20393) |
Enumeration Date | 2005-11-09 |
Last Update Date | 2019-03-22 |