| NPI | 1457397788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WI 52580-20) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ZZ 68057) |
| 208D00000X General Practice (Licence: SC 34024) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: WI 52580-20) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: SC 34024) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: SC 34024) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WI 52580-20) | |
| 202D00000X Integrative Medicine (Licence: SC 34024) | |
| 207Q00000X Family Medicine (Licence: SC 34024) | |
| 207R00000X Internal Medicine (Licence: SC 34024) | |
| 207R00000X Internal Medicine (Licence: WI 52580-20) | |
| 208000000X Pediatrics (Licence: SC 34024) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-03-15 |