NPI | 1386758613 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: IA 02075) |
Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: IA DO-2075) |
Enumeration Date | 2006-08-17 |
Last Update Date | 2023-11-22 |