NPI | 1356303242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MN 28548) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 28548) |
Enumeration Date | 2006-04-05 |
Last Update Date | 2020-11-10 |