| NPI | 1508020314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WA MD60380187) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IA 38958) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: WA MD60380187) | |
| 207Q00000X Family Medicine (Licence: WA MD60380187) | |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2013-08-30 |