NPI | 1326206897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 068243) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IL 036-117456) |
207QG0300X Family Medicine, Geriatric Medicine (Licence: AL 29408) | |
Enumeration Date | 2008-05-30 |
Last Update Date | 2019-11-26 |