| NPI | 1235561259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: FL ME146304) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-00574) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NC 2018-00574) | |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: MN 61883) | |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: NC 2018-00574) | |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2020-10-21 |