NPI | 1194260042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MD 3484) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD 3484) |
Enumeration Date | 2017-01-02 |
Last Update Date | 2023-07-03 |