| NPI | 1396205175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MA 292308) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MA 292308) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-04-15 |