| NPI | 1225059439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MT MED-PHYS-LIC-131634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00034054) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OR MD201549) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2024-03-08 |