NPI | 1548345952 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 15815) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ 15815) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2011-03-22 |