| NPI | 1225130099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 55115) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: GA 055115) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2016-09-22 |