NPI | 1699756312 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME74124) |
Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME74124) |
Enumeration Date | 2005-11-09 |
Last Update Date | 2021-12-01 |