NPI | 1013954213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0036786) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0036786) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2022-01-08 |