| NPI | 1023329802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: DC MD041163) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 8043674471) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0077856) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2021-05-27 |