| NPI | 1811979883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: AZ 43291) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01047116A) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2015-05-26 |