NPI | 1356395826 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: CA A67896) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A0678960) |
Enumeration Date | 2006-05-20 |
Last Update Date | 2015-09-21 |