| NPI | 1720002207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: KY 40202) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01032904A) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IN 01032904A) | |
| 207Q00000X Family Medicine (Licence: KY 40202) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-02-29 |