| NPI | 1851356398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MD426963) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A96510) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A96510) | |
| 208M00000X Hospitalist (Licence: CA A96510) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2021-11-22 |