| NPI | 1447664420 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: KY 49991)  | 
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IN 01082493A)  | 
| 207Q00000X Family Medicine (Licence: IN 01082493A)  | |
| 207Q00000X Family Medicine (Licence: KY 49991)  | |
| Enumeration Date | 2014-06-17 | 
| Last Update Date | 2023-05-06 |