| NPI | 1346450970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA c168949) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO 2007025194) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: DC MD041355) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2026-09-14 |