NPI | 1902367808 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME164003) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME164003) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2023-12-27 |