| NPI | 1578942843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: MN 60886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60886) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2021-09-01 |