| NPI | 1316052392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 26598) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CO 26598) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2026-03-17 |