NPI | 1700867215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R6979) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO R6979) |
Enumeration Date | 2005-11-10 |
Last Update Date | 2012-09-28 |