| NPI | 1962457853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D16565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD8060) |
| 207Q00000X Family Medicine (Licence: CA G16665) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MD D16565) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA G16665) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: DC MD8060) | |
| 208U00000X Clinical Pharmacology (Licence: MD D16565) | |
| 208U00000X Clinical Pharmacology (Licence: DC MD8060) | |
| 208U00000X Clinical Pharmacology (Licence: CA G16665) | |
| 209800000X Legal Medicine (Licence: MD D16565) | |
| 209800000X Legal Medicine (Licence: DC MD8060) | |
| 209800000X Legal Medicine (Licence: CA G16665) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-08 |