| NPI | 1700834140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AZ 54010) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A52601) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A52601) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-12-12 |