NPI | 1538159124 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A55139) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A55139) |
Enumeration Date | 2005-10-25 |
Last Update Date | 2023-11-09 |