| NPI | 1295797413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 31499) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0031499) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO DR.0031499) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2025-03-31 |