NPI | 1336140524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0059479) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0059479) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2014-02-13 |