| NPI | 1699721605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 039650) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 039650) |
| 208D00000X General Practice (Licence: GA 039650) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-06-14 |