| NPI | 1386641322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS 8096) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL OS 8096) |
| 208VP0000X (Licence: FL OS8096) | |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2022-07-21 |