| NPI | 1689610511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A064556) |
| Additional Taxonomies | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: CA A64556) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2021-03-08 |