| NPI | 1659497287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 33873) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CO 33873) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2012-07-23 |