| NPI | 1740484427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: CO DR.0025237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 25237) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2016-03-22 |