| NPI | 1215028378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: FL OS6681) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS 668100) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2017-03-03 |