| NPI | 1194855734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NM MD2020-0324) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CO DR.0034519) |
| 207Q00000X Family Medicine (Licence: CO DR.0034519) | |
| 207Q00000X Family Medicine (Licence: NM MD2020-0324) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2023-11-20 |