| NPI | 1386376440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME173514) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME173514) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35.155260) | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2026-06-29 |