| NPI | 1578525382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 17763) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NV 17763) |
| 207Q00000X Family Medicine (Licence: AZ 34880) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2019-12-19 |