| NPI | 1770682874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 51551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 042809) |
| 207R00000X Internal Medicine (Licence: AL 17723) | |
| 207R00000X Internal Medicine (Licence: TN 28033) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: TN 28033) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TN 28033) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TN 28033) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CO 51551) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CO 51551) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CO 51551) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2017-03-16 |