| NPI | 1285627323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 36087) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: KS 04-44133) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2024-03-26 |