NPI | 1285693572 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A71642) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A71642) |
207R00000X Internal Medicine (Licence: CA A71642) | |
Enumeration Date | 2006-03-23 |
Last Update Date | 2021-11-11 |