| NPI | 1235106154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 40310) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TN 40310) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TN 40310) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2024-07-01 |