| NPI | 1275206757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI DOS-2607) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A20456) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: HI DOS-2607) | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2025-01-13 |