| NPI | 1467405779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2005-0529) |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: NM MD2005-0529) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-06-23 |