| NPI | 1861872525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD466535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264188) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA MD466535) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2019-12-23 |