| NPI | 1053409144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME49835) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL ME49835) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2023-01-12 |