NPI | 1346269883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME95779) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME95779) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2024-10-11 |