NPI | 1902898869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G34375) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA G34375) |
Enumeration Date | 2005-08-17 |
Last Update Date | 2015-07-07 |