| NPI | 1861790552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: GA 069937) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.016666) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2021-07-13 |