| NPI | 1548246242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WI 1800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101013909) |
| 207Q00000X Family Medicine (Licence: WI 1800) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2025-01-03 |