| NPI | 1942275334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR C4948) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C4948) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AR C4948) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2014-04-30 |