| NPI | 1790713451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 28595) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TN MD0000009984) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2009-01-14 |