| NPI | 1477567170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO 39362) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA C 51164) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2019-12-28 |