NPI | 1578791976 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX n7907) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX N7907) |
Enumeration Date | 2009-06-24 |
Last Update Date | 2018-11-21 |