| NPI | 1477565851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 19139) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NH 19139) |
| 207R00000X Internal Medicine (Licence: MI 4301116248) | |
| 207R00000X Internal Medicine (Licence: AZ 34277) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NH 19139) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2025-09-09 |