| NPI | 1275576514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: WV 2223) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: IL 036070966) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-08-25 |