| NPI | 1326254053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-00815) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2023-00815) |
| 207R00000X Internal Medicine (Licence: AL 28497) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NC 2023-00815) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2023-04-12 |