NPI | 1144225277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101038287) |
Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: VA 0101038287) |
Enumeration Date | 2005-06-15 |
Last Update Date | 2023-08-04 |