| NPI | 1023380664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MO 2014012623)  | 
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: KS 0544060)  | 
| Enumeration Date | 2012-01-28 | 
| Last Update Date | 2022-08-19 |