| NPI | 1619504917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: NH 25714) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: OH 35.144006) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-06-14 |