| NPI | 1194725267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AZ 9952) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 09952) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-08-09 |