NPI | 1164416517 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G29685) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 79889) |
Enumeration Date | 2005-08-31 |
Last Update Date | 2024-08-21 |