| NPI | 1932179512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX N1609) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MS 10264) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2009-06-22 |