| 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 |