| NPI | 1518079789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: GA 067021) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 47503) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 22372) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-03-09 |