NPI | 1760605745 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NY 242292) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 242292) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2023-07-21 |