| NPI | 1609166016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TN 51976) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TN 51976) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TN 51976) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2016-05-31 |