| NPI | 1326031006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2006018690) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 35929) |
| 207P00000X Emergency Medicine (Licence: MO 2006018690) | |
| 207P00000X Emergency Medicine (Licence: KS 0434165) | |
| 207Q00000X Family Medicine (Licence: IA 35929) | |
| 207Q00000X Family Medicine (Licence: KS 0434165) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: IA 35929) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: KS 0434165) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO 2006018690) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: KS 0434165) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MO 2006018690) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IA 35929) | |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2020-12-07 |