| NPI | 1730558800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL ME134940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME134940) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2020-06-30 |