| NPI | 1487899936 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WI 53397)  | 
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WI 53397-020)  | 
| 207R00000X Internal Medicine (Licence: WI 53397)  | |
| Enumeration Date | 2008-12-12 | 
| Last Update Date | 2025-10-03 |