| NPI | 1336217819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0027394) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D27394) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MD D27394) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2008-10-24 |