NPI | 1447664396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: KS 0540072) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2014019003) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2023-12-06 |