| NPI | 1851405179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G20648) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA G20648) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2011-07-13 |