| NPI | 1417904665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MN 38401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 223349) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-03-08 |