| NPI | 1760460810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL 00027118) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036-100600) |
| Enumeration Date | 2006-01-08 |
| Last Update Date | 2011-11-10 |