NPI | 1518018738 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 30528) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 058836) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2018-06-11 |