| NPI | 1073596847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: VT 042.0013387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD10890) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NY 248222) | |
| 207Q00000X Family Medicine (Licence: NY 248222) | |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2016-05-16 |