| NPI | 1144263146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D37458) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0037458) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2012-01-04 |