| NPI | 1053480202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME124986) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P4923) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2018-10-03 |