| NPI | 1508186867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 069773) |
| Additional Taxonomies | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: GA 069773) |
| 208D00000X General Practice (Licence: GA 069773) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2024-08-21 |