| NPI | 1336197250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 47085) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 047085) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: GA 47085) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-02-07 |