| NPI | 1336170083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C10002773) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IN 01051725A) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: DE C10002773) | |
| 207Q00000X Family Medicine (Licence: IN 01051725A) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2017-11-13 |