| NPI | 1972551364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TN 36834) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MS 31104) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-02-09 |