| NPI | 1043354764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO 27226) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 27226) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2014-04-25 |