| NPI | 1154697662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NC 2018-00353) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-00353) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2018-00353) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2021-02-10 |