| NPI | 1649251000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MA 80854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 80854) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2014-07-09 |