NPI | 1285163246 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AZ 60565) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R10852) |
Enumeration Date | 2017-06-05 |
Last Update Date | 2021-08-19 |