NPI | 1073552840 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA OS005407L) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS005407L) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2019-04-10 |