| NPI | 1578587770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME107455) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 4917279-1205) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-12-14 |