| NPI | 1750483061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301062355) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301062355) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2012-01-17 |