| NPI | 1053847152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: SD 12320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.008242) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2022-03-28 |