| NPI | 1629019856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: VA 0101029470) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9801256) |
| 207R00000X Internal Medicine (Licence: VA 0101029470) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NC 9801256) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 9801256) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101029470) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-02-06 |