| NPI | 1114982485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 10051)  | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MS 10051)  | 
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MS 10051)  | |
| Enumeration Date | 2006-04-19 | 
| Last Update Date | 2020-08-14 |