| NPI | 1215284187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX R7239) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-8381) |
| 207Q00000X Family Medicine (Licence: TX R7239) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: AR E-8381) | |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2024-01-31 |