| NPI | 1013910884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.160242) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 8376) |
| 207Q00000X Family Medicine (Licence: DC MD042758) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NH 8376) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2024-02-12 |