| NPI | 1790760106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine (Licence: CA C54266) |
| Additional Taxonomies | 2084H0002X Psychiatry & Neurology, Hospice and Palliative Medicine (Licence: NY 143908) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2014-07-21 |