| NPI | 1467663674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 37186) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: MI 4301089444) |
| 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: IA 37186) | |
| 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: PA MT184001) | |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2018-04-30 |