NPI | 1114998440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 19619) |
Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: KY 19619) |
Enumeration Date | 2006-01-26 |
Last Update Date | 2010-07-30 |