| NPI | 1851476030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 14031) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: SC 14031) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2024-04-09 |