| NPI | 1275758583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 6624) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MI 4301088267) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-06-12 |