| NPI | 1831148360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H43157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD H43157) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD H43157) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-11-21 |