| NPI | 1942385919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL OS7605) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS7605) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2013-09-18 |