| NPI | 1457640872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA A123039) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA a123039) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2017-09-19 |