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: DC MD041355) |
207QG0300X Family Medicine, Geriatric Medicine (Licence: MO 2007025194) | |
Enumeration Date | 2007-05-23 |
Last Update Date | 2023-11-02 |