NPI | 1750355699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: FL OS5792) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS5792) |
Enumeration Date | 2006-02-16 |
Last Update Date | 2021-11-08 |