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 |