NPI | 1801967096 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX J6722) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J6722) |
Enumeration Date | 2006-11-11 |
Last Update Date | 2009-05-05 |