| NPI | 1780690107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D007743) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: MD D77483) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-02-18 |