NPI | 1578663225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 15237) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 15237) |
Enumeration Date | 2006-09-23 |
Last Update Date | 2007-07-08 |