| NPI | 1699755942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AR E-0779) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-0779) |
| 2080H0002X (Licence: AR E-0779) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2017-09-07 |