NPI | 1376659623 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME166865) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-065325) |
Enumeration Date | 2006-08-21 |
Last Update Date | 2024-09-07 |