| NPI | 1609995018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NC 16747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 16747) |
| 207RH0000X Internal Medicine, Hematology (Licence: NC 16747) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2016-03-02 |