| NPI | 1053310003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: FL 43528) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: FL ME43528) |
| 207VH0002X Obstetrics & Gynecology Hospice and Palliative Medicine (Licence: FL ME43528) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2020-02-14 |