| NPI | 1376882563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AL MD.34716) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AL MD.34716) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2025-06-16 |