| NPI | 1487764783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA g67484) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA G67484) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-04-15 |