NPI | 1821341603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA OT024546) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C7-0017650) |
208D00000X General Practice (Licence: NY 307030) | |
Enumeration Date | 2012-10-18 |
Last Update Date | 2025-06-28 |