| NPI | 1851377550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NH 9284) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 9284) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2022-01-24 |