NPI | 1831327899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A155227) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35.122296) |
Enumeration Date | 2009-06-29 |
Last Update Date | 2022-08-10 |