NPI | 1922072396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP00000836) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA OP0836) |
Enumeration Date | 2006-02-14 |
Last Update Date | 2010-12-10 |