| NPI | 1659380657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A60156) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A60156) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A60156) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2023-03-09 |