| NPI | 1215290499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NV 15162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U6534) |
| 207Q00000X Family Medicine (Licence: NV 15162) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX U6534) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NV 15162) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2024-08-08 |