| NPI | 1972941375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX Q7836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q7836) |
| 208D00000X General Practice (Licence: AZ 51120) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2020-08-19 |