| NPI | 1184732109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME82125) |
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: FL me82125) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2025-09-12 |