NPI | 1760563118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301051594) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301051594) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2012-02-21 |