NPI | 1417954306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A45368) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A45368) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2016-11-23 |