| NPI | 1063601250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MI 5101015793) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 510105793) |
| 208000000X Pediatrics (Licence: MI 510105793) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2023-11-27 |