| NPI | 1326309055 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA A119206)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A119206)  | 
| Enumeration Date | 2012-05-29 | 
| Last Update Date | 2016-04-01 |