| NPI | 1679547731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: VA 0101268535) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 29097) |
| 207Q00000X Family Medicine (Licence: KY 29097) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-04-23 |