| NPI | 1407927130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086H0002X Surgery Hospice and Palliative Medicine (Licence: AZ 38215) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: AZ 38215) |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: AZ 38215) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2010-05-11 |