| NPI | 1528044674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS005483-L) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: PA OS005483L) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2022-02-10 |