| NPI | 1487848479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX N3317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N3317) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX N3317) | |
| Enumeration Date | 2007-09-01 |
| Last Update Date | 2020-10-29 |