| NPI | 1275694747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000034326) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TN 34326) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2024-11-01 |