NPI | 1548359490 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301039962) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MI 4301039962) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2012-03-29 |