| NPI | 1407875941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 00A511550) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A51155) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-01-02 |