NPI | 1285665828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: ME MD16511) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD16511) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2018-12-08 |