| NPI | 1184612921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TN 31287) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TN 31287) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2014-07-14 |