| NPI | 1053399659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MI 5101011807) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101011807) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2013-12-13 |