| 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 |