NPI | 1568462554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX F9338) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX F9338) |
Enumeration Date | 2005-07-31 |
Last Update Date | 2010-07-13 |