| NPI | 1841239969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TN 18771) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD18771) |
| 207Q00000X Family Medicine (Licence: VA 0101247663) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-02-26 |