| NPI | 1831930064 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: FL TRN41634) | 
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: KS 94-11677) | 
| Enumeration Date | 2024-06-03 | 
| Last Update Date | 2025-07-06 |