NPI | 1205042470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A120608) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 225913) |
207Q00000X Family Medicine (Licence: CA A120608) | |
207QG0300X Family Medicine, Geriatric Medicine (Licence: MA 235987) | |
Enumeration Date | 2007-05-15 |
Last Update Date | 2021-04-15 |