| NPI | 1871586727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: FL ME111601) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AL 24014) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2022-08-19 |