| NPI | 1588004600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NC 2019-02665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2019-02665) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NC 2019-02665) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2024-07-15 |