| NPI | 1578500542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MI 5101014627) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 5101014627) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-02-25 |