NPI | 1063810935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NV DO2633) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CO DR0057649) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-12-09 |
Last Update Date | 2022-11-01 |