| NPI | 1275519480 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME27676) | 
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME27676) | 
| Enumeration Date | 2005-12-20 | 
| Last Update Date | 2021-08-13 |