| NPI | 1437281961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D33357) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MD D33357) |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2013-08-21 |