| NPI | 1750654232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: NY 281402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-250357) |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: MA 250357) | |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2015-09-13 |