| NPI | 1417920646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 99-00115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 20602) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 99-00115) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SC 20602) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: SC 20602) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NC 99-00115) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2021-06-30 |