NPI | 1487031068 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WA OP61258574) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.146342) |
207Q00000X Family Medicine (Licence: WA OP61258574) | |
Enumeration Date | 2015-05-02 |
Last Update Date | 2023-04-03 |