| NPI | 1639550890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA MD471234) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WI 68882-20) |
| 207R00000X Internal Medicine (Licence: IL 125067087) | |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2020-09-08 |