| NPI | 1205944907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: CA A55704) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A55704) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-08-22 |