| NPI | 1932266103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A93803) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA A93803) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A93803) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-09-22 |