| NPI | 1548232317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX J7334) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX J7334) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2022-10-13 |