NPI | 1215152442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M6862) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX M6862) |
Enumeration Date | 2007-04-14 |
Last Update Date | 2017-01-09 |