| NPI | 1194353557 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AZ 77132) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 73791) | 
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MN 73791) | |
| Enumeration Date | 2020-03-31 | 
| Last Update Date | 2025-06-16 |