| NPI | 1689705618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: PA os004813L) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: DE C2-0007569) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA os004813L) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: DE C2-0007569) | |
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: DE C2-0007569) | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2016-11-25 |