NPI | 1457580532 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY A259723) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY A259723) |
Enumeration Date | 2009-07-09 |
Last Update Date | 2016-08-25 |