| NPI | 1255405502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA MD450465) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A102580) |
| 207R00000X Internal Medicine (Licence: VA 101240475) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-07-31 |