| NPI | 1932178829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: KY 26004) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IN 01039937A) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-06-21 |