| NPI | 1942738679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: CA 20A18014) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: CA 20A18014) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2025-09-05 |