| NPI | 1295720217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: VA 0101265008) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 37934) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2023-08-11 |