| NPI | 1932118767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX K8341) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX K8341) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2017-03-08 |