| NPI | 1801900568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX S2162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01053457A) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-01-23 |