NPI | 1730168303 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 14949) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 14949) |
Enumeration Date | 2006-01-12 |
Last Update Date | 2021-07-24 |