NPI | 1174591002 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 14990) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OK 14990) |
Enumeration Date | 2006-03-08 |
Last Update Date | 2007-07-08 |