| NPI | 1285605113 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OK 21872)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 21872)  | 
| Enumeration Date | 2006-01-30 | 
| Last Update Date | 2015-12-03 |