| NPI | 1285627323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-44133) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 36087) |
| 207Q00000X Family Medicine (Licence: MO 2020042715) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: KS 04-44133) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2025-03-10 |