| NPI | 1609309681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NM MD2022-1022) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX T6514) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2022-08-25 |