| NPI | 1538693940 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX U5563) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U5563) | 
| Enumeration Date | 2017-04-12 | 
| Last Update Date | 2023-10-07 |