| NPI | 1841391208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200301078) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200301078) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NC 200301078) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2025-02-24 |