| NPI | 1487753091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 34069) |
| Additional Taxonomies | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: KY 34069) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2024-09-12 |