| NPI | 1477548964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS5538) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: FL OS 5538) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2023-06-26 |