| NPI | 1639346554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO 45568) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101242961) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2021-08-30 |