| NPI | 1568457372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: KY 39435) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 39435) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2010-08-31 |