NPI | 1568438208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D0020040) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0020040) |
Enumeration Date | 2006-02-23 |
Last Update Date | 2014-12-05 |