| NPI | 1548722598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: GA 104848) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD485907) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD485907) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-06-05 |