| NPI | 1083811087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101287709) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX P7453) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: IA MD-44381) | |
| 207Q00000X Family Medicine (Licence: SD 7039) | |
| 207Q00000X Family Medicine (Licence: IA MD-44381) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IA MD-44381) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2026-02-23 |