| NPI | 1164719779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AZ 50163) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NE 19358) |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2023-03-07 |