| NPI | 1730303470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301093174) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL ME98114) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-12-27 |