NPI | 1366448771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 20821) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: SC 20821) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2019-12-17 |