| NPI | 1518933985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 74526-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 37224) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MN 37224) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2024-07-03 |