| NPI | 1174985345 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MI 4301504101) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301504101) | 
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: MI 4301504101) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MI 4301504010) | |
| Enumeration Date | 2016-03-25 | 
| Last Update Date | 2025-09-26 |